Mortgage Short Form Step 1 of 5 20% FICO Score* Loan Amount* Property Value* Subject Property Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Occupancy %* Loan Purpose*Please SelectPurchaseRefinance/TermCash Out RefinanceConstruction OnlyConstruction to PermanentBridge LoanHard MoneyFix and FlipBlanket / Portfolio LoanOtherOccupancy Type*Please SelectOwner OccupiedInvestmentVacantProperty Type:*Please SelectSingle FamilyDuplexTriplexFourplexMulti FamilyCondominiumTown HomeMobile Home ParkRetailOfficeRestaurant/BarMix Use (more than 50%)Mix Use (less than 50%Light IndustrialDay CareAutomotiveHotel MotelSpecial AssetRV ParkFuneral HomeWarehouseSelf StorageAssisted LivingHealthcareStudent HousingAffordable HousingManufactured HousingExisting Mortgage?* Yes No Annual Rents: Annual Expenses: Net Operating Income Yrs experience RE Transactions 5 yrs? Original Purchase Date Original Purchase Price Loan balance Current Rate Monthly Payment Cost of Improvements Property taxes Due Name:* Email* Phone*Any Bankruptcy, Foreclosure or Short sales in last 3 years?*NoBankruptcyForeclosureShort SaleBankruptcy, Foreclosure or Short Sale Date? Mortgage lates in the last 12 months?No30 Days60 Days90 Days120 DaysNameThis field is for validation purposes and should be left unchanged.